精浆中GDF-15对妊娠结局的影响

Effects of GDF-15 in seminal plasma on pregnancy outcomes

目的比较人工授精(IUI)与自然妊娠之间妊娠结局的差异,探讨男性精浆在早期妊娠中的作用。方法收集2015年1月-2017年12月于本院生殖医学科就诊的326例妊娠患者数据,其中经IUI妊娠者190例,自然妊娠者136例。比较IUI和自然妊娠之间早期妊娠丢失率、中晚期流产率以及活产率的差异,并探讨精浆中生长分化因子15(GDF-15)对子宫内膜容受性的影响。结果IUI妊娠组与自然妊娠组在早期妊娠丢失率(34.73%vs.22.06%)和活产率(61.17%vs.75.19%)方面存在统计学差异(P均<0.05),OR值分别为1.88(95%CI:1.14~3.11)和0.52(95%CI:0.32~0.85)。进一步体外实验显示:rhGDF-15可以上调小鼠子宫内膜中LIF、Integrinανβ3和HOXA 11基因的表达。结论精浆因素可能是导致IUI与自然妊娠之间妊娠结局差异的原因;精浆中GDF-15对子宫内膜容受性有潜在的益处。

Objective To investigate the role of male seminal plasma in early pregnancy by comparing the difference of pregnancy outcomes after artificial insemination(IUI)and natural pregnancy.Methods Data of 326 pregnant patients admitted to our center during Jan.2015 and Dec.2017 were collected,including 190 cases of IUI pregnancy and 136 cases of natural pregnancy.The differences in early pregnancy loss rate,middle and late abortion rates and live birth rate between the IUI group and natural pregnancy group were compared,and the effects of growth differentiation factor 15(GDF-15)in seminal plasma on endometrial receptivity were investigated with molecular biology techniques.Results Between the IUI group and natural pregnancy group,there were significant differences in early pregnancy loss rate(34.73%vs.22.06%)and live birth rate(61.17%vs.75.19%),and the OR value was 1.88(95%CI:1.14—3.11)and 0.52(95%CI:0.32—0.85).Furthermore,in vitro experiments showed that rhGDF-15 up-regulated the expressions of LIF,Integrinανβ3 and HOXA 11 genes in mouse endometrium.Conclusion Seminal plasma may be the cause of differences in pregnancy outcomes between IUI and natural pregnancy.GDF-15 in seminal fluid has a potential benefit on endometrial receptivity.